Antidepressants should not be ruled out as treatment for young people with depression, especially since recent studies have shown no connection between these medications and suicide in younger patients, according to an article in the latest Medical Journal of Australia.
Professor Robert Goldney, Professor of Psychiatry at The University of Adelaide, says it is important to look at all the available evidence, not just randomised clinical trials, before making assumptions about a link between antidepressants and suicidal behaviour.
"Real-life clinical monitoring may be the only way in which clinicians and drug regulators can make reasoned decisions about some treatments," Prof Goldney says.
In his article, Prof Goldney reviewed several such studies from around the world, and found little evidence to suggest antidepressant use made young people prone to suicide.
"Furthermore, there is concern that the reduced prescribing of antidepressants to young people may be associated with an increase in youth suicide in the United States," Prof Goldney says.
In light of this, he says, it is not unexpected that one study concluded that the benefits of antidepressants appear to be much greater than the risks from suicidal behaviour or attempts.
Prof Goldney says that his review of recent research should not be interpreted as promoting uncritically the use of antidepressants in young people.
"Antidepressants are not necessarily first-line treatment, and they should be used only as an adjunct to psychosocial and cognitive behavioural therapies, and after consultation with the patient and family."
No antidepressant has as yet been approved for use in major depression in children and adolescents in Australia.
The Medical Journal of Australia is a publication of the Australian Medical Association.